Hallström Erling, Kärrholm Johan
Department of Orthopaedics, Uddevalla Hospital, Gothenburg, Sweden.
J Shoulder Elbow Surg. 2008 Jan-Feb;17(1 Suppl):40S-47S. doi: 10.1016/j.jse.2007.09.001.
To study the kinematics of the glenohumeral joint during the testing of the Neer and Hawkins signs, we used dynamic radiostereometry. Eighteen patients with impingement syndrome (Neer stage 2) and eleven controls were included. During testing of the Neer sign, there was no significant difference in humeral rotation and translation between patients and controls. During testing of the Hawkins sign, the center of the humeral head was positioned more laterally and superiorly in controls than in patients. The maximum amount of abduction, either relative glenohumeral rotation or as absolute rotation, was not influenced by the presence of impingement symptoms. Absence of kinematic abnormalities during the Neer maneuver and changed humeral translation in the Hawkins position suggest that the latter test is a more sensitive diagnostic tool. Our findings do not support that abnormal passive shoulder motions precede development of impingement syndrome.
为了研究在Neer征和Hawkins征检查过程中盂肱关节的运动学,我们采用了动态放射立体测量法。纳入了18例撞击综合征(Neer 2期)患者和11名对照者。在Neer征检查过程中,患者与对照者之间在肱骨旋转和移位方面无显著差异。在Hawkins征检查过程中,与患者相比,对照者肱骨头中心位置更偏外侧和上方。外展的最大幅度,无论是相对盂肱关节旋转还是绝对旋转,均不受撞击症状存在与否的影响。Neer动作过程中无运动学异常以及Hawkins位时肱骨移位改变提示,后一种检查是更敏感的诊断工具。我们的研究结果不支持异常的被动肩部运动先于撞击综合征发生。